‘Is this normal?’ Addressing postpartum health concerns

As a new mom, I frequently find myself asking, “is this normal?” Often, it is about my baby. I wonder whether she is eating enough, whether she is gaining enough weight, and whether she is sleeping enough or too much. Luckily, she is healthy, and I have routine trips to her wonderful pediatrician and 24-hour access to a nurse to ask those normal questions new mothers ask.

For me and my body, though, it’s different. In the days and weeks following my delivery, I wonder if what I am experiencing is normal. Are the changes to my post-partum body expected in an uncomplicated delivery, or do they require medical attention?

I was fortunate to have a relatively swift and easy childbirth. Other women are not nearly as lucky. They might be left with debilitating injuries such as urinary or anal incontinence and pain, sometimes for years after delivering their babies.

Jessica Roberts, J.D., with her newborn.

As I talk to my female friends without children, I am often met with confusion and disbelief. Several are unaware of the simple realities of childbirth, like needing to change my own diaper as I change that of my newborn because I will bleed for weeks after delivery.

Some are surprised by biological truths that should be included in basic health education, like how the placenta works. In this way, we fail women before they become pregnant by not talking frankly and openly about both the good and bad of childbirth.

It is well-documented that America falls short in the realm of maternal mortality. Twenty eight out of every 100,000 women will die due to complications from pregnancy and childbirth in the United States. Texas has the unfortunate honor of having the worst maternal mortality in the nation. And even if a woman does not die, the system continues to fail her in many ways after she delivers. But why?

Some of these shortfalls occur because postpartum women find themselves in medical limbo. While a newborn has access to pediatricians and neonatal specialists, an obstetrician’s obligation to care for a mother is largely discharged after she safely delivers the baby.

To fill the gap in skilled medical care, we construct an informal network of information that can cause more harm than good. We look to our mothers, sisters, and friends to stand in for medical professionals. Primary sources of medical consultation and advice become friends and family who have already been through the same experiences, some dismissing even serious birth injuries as just a fact of life because they were told the same thing.

More dangerous still, we look to the internet to tell us if our experience is normal. While this information gathering can be empowering, it can also be overwhelming and distressing. In my experience, online message boards and blogs can perpetuate a type of toxic mom-shaming, in which some mothers insist that their method of mothering is the only right way, and all other decisions are wrong or even harmful.

These kinds of interactions can shake an already vulnerable new mom as she tries to navigate an unfamiliar world with her newborn, adding psychological injury to individuals who may already be suffering from post-partum depression and anxiety.

I cannot help but feel guilty for focusing on my own health when I have a newborn in my care. Guilt is surely an epidemic in motherhood. However, I want to challenge this idea that post-partum women should simply be grateful for a healthy baby. We deserve better for ourselves.

The most routine and speedy delivery is still a brutal and taxing event for even the healthiest of bodies. As I try to understand and care for my post-partum body, I can’t help but look critically at the post-partum care routinely covered by insurance in our country. In response, I can’t help but ask: “Is this normal? Or can we do better?”

-By Jessica L. Roberts, J.D., health policy scholar in the Center for Medical Ethics and Health Policy at Baylor College of Medicine, George Butler research professor of law at the University of Houston Law Center and director of the Health Law and Policy Institute 

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